Bilingual Sr Claims Adjudicator Job in East York

Admin

East York

As a Member of the Claims Service team this position is responsible for the assessment and payment of death claims while adhering to all regulatory and policy contract provisions.

Responsibilities:• Responsible for the adjudication of death claims: collects and reviews all relevant information to determine legitimacy, eligibility and benefit amount payable• Performs all required calculations and ensures all activities are in compliance with legal client standards• Communicates verbal and written information as appropriate to those with a need to know. Ensures information is clear, accurate and consistent with all legal, privacy, confidentiality and company standards.• Follows through on all outstanding items in a timely basis as per service level agreements. Commitment to take ownership and to resolve client issues and concerns to the satisfaction of the client and business unit.• Refers questionable/contentious claims to management and/or client for evaluation as needed and provide recommendation for actions.• Maintains and updates all applicable system records

Experience/Skills:• Minimum 3 years’ experience in adjudication including the investigation and detailed reporting of life insurance claims• Demonstrated mathematical aptitude and strong data analysis skills with attention to detail and accuracy.• Understanding of Canadian Life insurance products and applicable insurance laws• Good verbal and written communication skills to effectively communicate with internal and external customers/partners and vendors.• Critical thinking, customer service skills, time management, problem solving, decision-making, interpersonal skills and adaptability/flexibility.• Pursuing ALHC, FLMI or ACS• Must be able to work independently with little supervision in a team environment.• Required education: Bachelor's• Required experience: life insurance: 4 years• Required language: French